| NPI | 1396707956 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080N0001X Pediatrics Neonatal-Perinatal Medicine (Licence: NY 250320) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NY 000974) |
| 2080N0001X Pediatrics Neonatal-Perinatal Medicine (Licence: NY 000974) | |
| Enumeration Date | 2006-04-06 |
| Last Update Date | 2013-02-26 |